Skinner Harlyn G, Calancie Larissa, Vu Maihan B, Garcia Beverly, DeMarco Molly, Patterson Cam, Ammerman Alice, Schisler Jonathan C
Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
PLoS One. 2015 May 4;10(5):e0125466. doi: 10.1371/journal.pone.0125466. eCollection 2015.
Heart Healthy Lenoir is a transdisciplinary project aimed at creating long-term, sustainable approaches to reduce cardiovascular disease risk disparities in Lenoir County, North Carolina using a design spanning genomic analysis and clinical intervention. We hypothesized that residents of Lenoir County would be unfamiliar and mistrustful of genomic research, and therefore reluctant to participate; additionally, these feelings would be higher in African-Americans.
To test our hypothesis, we conducted qualitative research using community-based participatory research principles to ensure our genomic research strategies addressed the needs, priorities, and concerns of the community. African-American (n = 19) and White (n = 16) adults in Lenoir County participated in four focus groups exploring perceptions about genomics and cardiovascular disease. Demographic surveys were administered and a semi-structured interview guide was used to facilitate discussions. The discussions were digitally recorded, transcribed verbatim, and analyzed in ATLAS.ti.
From our analysis, key themes emerged: transparent communication, privacy, participation incentives and barriers, knowledge, and the impact of knowing. African-Americans were more concerned about privacy and community impact compared to Whites, however, African-Americans were still eager to participate in our genomic research project. The results from our formative study were used to improve the informed consent and recruitment processes by: 1) reducing misconceptions of genomic studies; and 2) helping to foster participant understanding and trust with the researchers. Our study demonstrates how community-based participatory research principles can be used to gain deeper insight into the community and increase participation in genomic research studies. Due in part to these efforts 80.3% of eligible African-American participants and 86.9% of eligible White participants enrolled in the Heart Healthy Lenoir Genomics study making our overall enrollment 57.8% African-American. Future research will investigate return of genomic results in the Lenoir community.
“心系勒诺尔健康项目”是一个跨学科项目,旨在通过涵盖基因组分析和临床干预的设计,创建长期、可持续的方法,以减少北卡罗来纳州勒诺尔县心血管疾病风险差异。我们假设勒诺尔县的居民对基因组研究不熟悉且不信任,因此不愿参与;此外,非裔美国人的这些情绪会更高。
为了验证我们的假设,我们采用基于社区的参与性研究原则进行定性研究,以确保我们的基因组研究策略满足社区的需求、优先事项和关注点。勒诺尔县的19名非裔美国成年人和16名白人成年人参加了四个焦点小组,探讨对基因组学和心血管疾病的看法。进行了人口统计学调查,并使用半结构化访谈指南来促进讨论。讨论进行了数字录音,逐字转录,并在ATLAS.ti中进行分析。
通过我们的分析,出现了关键主题:透明沟通、隐私、参与激励和障碍、知识以及知晓的影响。与白人相比,非裔美国人更关注隐私和社区影响,然而,非裔美国人仍然渴望参与我们的基因组研究项目。我们的形成性研究结果被用于改进知情同意和招募过程,方法如下:1)减少对基因组研究的误解;2)帮助促进参与者对研究人员的理解和信任。我们的研究展示了如何利用基于社区的参与性研究原则来更深入地了解社区,并增加对基因组研究的参与度。部分由于这些努力,80.3%符合条件的非裔美国参与者和86.9%符合条件的白人参与者参加了“心系勒诺尔健康基因组学研究”,使我们的总体参与率达到57.8%为非裔美国人。未来的研究将调查勒诺尔社区基因组结果的反馈情况。